Contexts of Nursing: An Introduction

This exemplifies spirituality in the religious and existential or universal sense. It does not only involve a relationship with others but also with oneself , something within a person, without which life would not be worth living [ 27 ]. Finding meaning in life involved contextualizing health conditions by reflecting on the purpose of life or by outlining life goals and personal philosophies [ 21 ].

Finding the meaning of life was a dynamic, individual process that changed moment-to-moment and day-to-day events. It involved weighing the risk versus benefit, processes versus outcomes, good versus evil by means of introspection and reflection [ 28 ]. Spirituality as manifested in nature was expressed as the joy of seeing grass and trees and the desire to go for walks [ 26 ].

Those who were unable to walk wished to look at the trees surrounding the garden and to have flowers from the garden in their room. Patients reported the need to read inspirational texts several times each day or to sing and listen to music [ 26 ]. Several personality traits and attitudes were characterized as self-affirming: Spirituality was characterized as an inner force that provided insights into how to reduce anger , bitterness and fear in order to maintain a positive outlook [ 30 ].

According to Walton [ 23 ], spirituality creates inner strength and courage by providing the energy to face the next step in life, which leads to a sense of wellness and has a positive impact on health. A prerequisite for spirituality is a relationship characterized by mutuality, trust, ongoing dialogue and enduring presence.

When ministering to patients, caregivers struggled to establish spirituality b y creating a balance between the holistic and biomedical perspectives. It was the connection to the place of silence that enabled caregivers to acknowledge the hope and fear inherent in caring. Resting in a place free from fear facilitates genuine human connection, where presence with the patient can be felt and deepened [ 22 ]. Spirituality in caring was described as an invitation, encountering the patient as a unique person [ 31 ].

According to Tirgari et al. Active listening requires nurses to be fully present , especially when patients appear depressed or upset [ 31 ]. Spirituality in caring therefore involves the ability to build confidence by listening to or just being with the patient [ 33 ]. In caring , confidence implies self-awareness, being non-judgemental and consistent as well as able to identify patient needs.

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This requires putting aside personal needs to avoid dominating the spirituality in the caring process [ 25 ]. It involves one human being responding to another with genuine understanding, openness and warmth [ 33 ] and encompasses patience, compassion, loyalty and honesty [ 23 , 33 ]. Spiritual commitment develops into a meaningful notion and merges with sympathy, conscientious care, commitment and devotion [ 34 ]. Caregivers with this approach described caring as enjoyable and preferred it to the higher status of a more senior position [ 34 ].

Caregivers who took this perspective valued patient wellbeing more than their own, mainly because they regarded providing care as a form of worship. Such spiritual love and affection maintained an energetic approach to nursing [ 34 ]. A close relationship was important and touch was used to provide comfort in situations characterized by anxiety and physical pain [ 31 ]. The meaning of spirituality was described as caregivers encountering patients as cultural beings [ 31 ] , which involved allowing them and their family members to express their feelings.

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Engaging in spiritual matters comprised beliefs and values that gave meaning and worth to existence [ 27 ]. According to Tanyi et al. According to Walton [ 28 ], a desire to help others in need is an important part of spirituality, which is also described as a life-giving force based on faith, discovering meaning and purpose in life and offering the gift of self to others [ 24 ]. Seeking balance in life involves everyday choices as well as setting goals and moving beyond personal requirements to those of others [ 28 ]. The need to contribute by helping to care for others is important, even in cases where the other is sick and close to death [ 26 ] as it is an expression of love, compassion and altruism [ 27 ].

Helping others also brings a sense of self-worth, personal fulfilment and satisfaction [ 28 ]. Patients at the end of life described a need to view their life, which was subject to an ongoing revision process [ 21 ]. Reviewing life evoked happy thoughts and helped them to understand why things happened as they did, despite at times experiencing profound unhappiness [ 26 ]. It was important to undertake things one had wanted to do such as going on trips and carrying out tasks, for example making funeral arrangements in order to find peace before death. Taking one day at a time represented an expression of spiritual value and had they not done so, they would have been unable to manage [ 26 , 30 ].

Children were important at the end of life, as they were a reminder that life goes on and that another generation has hopes and dreams.

Contexts Of Nursing An Introduction

Despite poor appetite it was important to join family members for meals [ 26 ]. Engaging in spiritual matters indicated personal transformat-ion comprising a change of life direction and a new way of thinking. Spiritual engagement included prayer and was perceived as powerful, uplifting and helpful [ 27 ].

This integrative review attempts to describe experiences of the positive impact of spirituality and spiritual values in the context of nursing. It is difficult to draw any firm conclusions on the basis of the results, as spirituality comprises many perspectives at different levels of awareness [ 11 ]. However, the results revealed that spirituality was viewed as inclusive, fluid and personal. In the context of nursing, demands on caregivers are heavier when they have to provide insights into spiritual matters during encounters with patients. According to Carson [ 36 ], the development of spirituality is a dynamic process in which a person becomes aware of the meaning, aim and values of life, including all relationships.

It requires openness and sensitivity on the part of caregivers and becomes visible in virtue ethics [ 37 , 38 ]. In virtue ethics, the human being is viewed as a whole, comprising body, mind and spirit. However, the authenticity of the human relationship is important, as in the absence of authenticity, there can be no humanity. In such meetings spiritual values are fundamental, unlike encounters where the caregiver views the patient as an object, thus excluding spiritual values. The findings demonstrated that in an environment where spirituality can grow, the meeting between the caregiver and patient involved two subjects in a relationship of togetherness.

Human beings try to alleviate their suffering in different ways [ 39 ]. In the present study, patients with various types of serious illness described how they attempted to alleviate their suffering by creating meaning, manifested as a new inner spiritual attitude that helped them to reconcile themselves with their changed life situation and prepared them to meet the fate that awaited them. Spiritual values in the creation of meaning included building a source of energy, development and hope linked to mutual giving and taking, helping and being helped.

It is the release of a spiritual force that pulls the person along in a movement out from the self. This integrative literature review provides an overview of some of the knowledge in the field of spirituality and spiritual values in the context of nursing, although it is possible that some relevant studies may not have been included given the limitations of this review [ 17 ]. Another weakness is the different meaning of the concepts of spirituality and spiritual values used in the analyzed articles, which contain no definition of the terms.

Clarification of these concepts and values was therefore challenging, which should be kept in mind when criticizing this review. Because of the limitations and inconsistencies in the findings, additional research is needed to clarify the meaning and definition of spirituality and spiritual values in the context of nursing. The concepts of spirituality and caring were perceived as having the same meaning and no difference between them was reported. However, it was obvious that spirituality and spiritual values in the context of nursing are closely intertwined with the concept of caring.

A caring attitude, spirituality and spiritual values belong together and should be the guiding inspiration for all nurses. It is the responsibility of nursing leadership and the organization to ensure that this is achieved. We are grateful to University West for financial support as well as Gullvi Nilsson and Monique Federsel for scrutinizing the English language. GR is the main author and responsible for the study conception as well as the design of the introduction and method sections. She collected and analyzed the data in addition to drafting the manuscript and carrying out critical revisions.

IB collected and analyzed data , drafted the manuscript and made critical revisions. ABS contributed to the drafting of the manuscript and the final critical revision. All authors approved the final version of this manuscript. The authors confirm that this article content has no conflict of interest. National Center for Biotechnology Information , U. Journal List Open Nurs J v.

Published online Dec Author information Article notes Copyright and License information Disclaimer. This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License http: This article has been cited by other articles in PMC. Abstract Spirituality is often mistakenly equated with religion but is in fact a far broader concept. Humanity, integrative review, inner strength, spirituality, togetherness, wholeness. AIM The aim of this integrative review was to describe experiences of the positive impact of spirituality and spiritual values in the context of nursing.

Study Selection Criteria Studies considered for inclusion were qualitative research papers, primary sources dealing with spirituality in the nursing context and empirical or theoretical literature published in the English language. Search Outcome A total of 97 studies were identified. Presentation of the studies included in the integrative review.

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A theoretical discussion article. Six staff members, 5 female and 1 male, at two Hospice organizations. Average age, 57 years. Semi structured interviews conducted over the telephone. Telephone interviews with family members. Open-ended questions describing what the staff did to meet the spiritual needs of the residents.

Six focus group interviews. The data were thematically coded. Mean age 46 years between 20 and 59 years.

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Four palliative care clients, two female and two male between years, as well as four current and six former, eight female and two male between years. Mean age 72 years. Face-to face in depth interviews. In-depth interviews with open-ended questions. Descriptive phenomenological methodology Colaizzi In-depth interviews with open-ending questions Descriptive phenomenology Colaizzi Tirgari B. Mean nursing experience was 10 years.

In-depth, individual, unstructured audio taped interviews with a narrative approach. Phenomenological hermeneutics influenced by Ricoeur, as described by Lindseth and Norberg Open in a separate window. Analysis Data reduction involved categorizing the data from each article in a matrix based on the study type.

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Being Part of a Greater Wholeness Spirituality was described as the integration of body, mind and spirit in to a harmonious whole [ 21 ]. Ministering to Patients A prerequisite for spirituality is a relationship characterized by mutuality, trust, ongoing dialogue and enduring presence.

God and the unconscious. Stockholm Natur och Kultur. The relation between psychology, religion and health Anchoring and renewal. Teaching spirituality in nursing a literature review. Spirituality the Holy Grail of contemporary nursing practice. Swinton J, Pattison S. Moving beyond clarity towards a thin, vague, and useful understanding of spirituality in nursing care. Spiritual care in nursing an overview of the research to date.

Towards clarification of the meaning of spirituality. The essence of spirituality Spiritual dimensions of nursing practice. Philadelphia WB Saunders Co. J Pain Symptom Manage. An integrative review of spiritual assessment implications for nursing management. Creating conditions for good nursing by attending to the spiritual. Daly, Speedy and Jackson Publisher: Elsevier Used but in good condition.

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